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May 1960

The "Combined" Operation for Peptic Ulcer

Author Affiliations

From the Department of Surgery, University of Washington School of Medicine, and from the Surgical Service, King County Hospital, Seattle Veterans Administration Hospital, and Spokane Veterans Administration Hospital.; Professor of Surgery, University of Washington School of Medicine; Surgeon-in-Chief, King County Hospital; Chief Consultant in Surgery, Seattle Veterans Administration Hospital; Consultant in Surgery, Spokane Veterans Administration Hospital (Dr. Harkins). Instructor in Surgery; Chief Resident in Surgery, King County Hospital (Dr. Jesseph). Assistant Professor of Surgery (Dr. Stevenson); Associate Professor of Surgery (Dr. Nyhus), University of Washington School of Medicine.

AMA Arch Surg. 1960;80(5):743-752. doi:10.1001/archsurg.1960.01290220035006

In 1953 we published the early results of a "combined" operation for peptic ulcer, comprising partial distal gastrectomy (antrectomy), vagotomy, and gastroduodenal (Billroth I) reconstruction.11 Since that time, our experience in the application of this operation has enlarged, and we are now able to provide data on a group of 137 patients treated by this operation, some of whom have been followed for eight years.

An increasing number of centers have adopted partial distal gastrectomy and vagotomy as the operation of choice for the treatment of complicated or chronic duodenal ulceration, and their published reports lend ever-increasing support to its worth.1,5,7,8, 12-14 The concepts upon which this operation is founded are of both experimental and clinical origin. The importance of the antral and the cephalic phases of gastric acid secretion has been shown experimentally by many investigators, and their laboratory findings have been corroborated by clinical experience.2,3,4,13,15,17,18,20

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